Mary got back to the house minutes after John did, plastic carrier bag full of takeaway in hand as promised.
'How's Cath?' he asked.
'Oh, you know,' she said, as she pulled plates out of the kitchen cupboard, and John started pulling the lids off the plastic containers of curry. 'She should call it a day with him really, but she's still in the pre-contemplative stage of telling him to piss off.'
'Pre-contemplative?'
'Yeah you know, like with the stages of dealing with addiction?'
John looked blank. He'd obviously 'deleted' that part of his medical education, although it looked as if it was all going to get a little more relevant now. He was starting to wish that he'd paid more attention in his psychiatry lectures.
Mary shook her head at him and sighed in mock despair. 'The pre-contemplative stage is when people are trying hard to ignore the fact that they've got a problem,' she said. 'Next comes the contemplative stage, when people acknowledge that they've got a problem, but can't work out what to do about it, then preparation, then action. Basically, Cath's got a long way to go before she sees sense and kicks the stupid bastard out on his ear.'
'And which stage do you think Sherlock's at?' John asked, slowly.
'You really think that he's got a problem? With drugs? I thought that he said that it was all for a case?'
'And you believe him?'
'I - I'm not sure. You should give him a chance to explain though John, surely, before you jump to conclusions. You know what he's like. There may be a reasonable explanation. And even if he is using, it doesn't necessarily mean that he's addicted.'
'Oh Mary,' John said, walking over to her, and wrapping her into a hug. 'I wish that I had your faith in humanity.'
'You mean that you think that I'm naive?'
'No, I mean what I say. But maybe you're right. Either way, I don't want to think about it tonight. I want to eat Indian takeaway with my beautiful wife, watch crap telly, and try very hard not to think about the mess that Sherlock Holmes has got himself into this time.'
...
Exactly how big a mess became apparent not long after John walked into Sherlock's room early the next afternoon. When he'd phoned ITU in the morning, he'd been told that they were about to transfer Sherlock onto the private ward. They'd suggested that he give them a few hours to get him settled before visiting, so he'd delayed his visit until later than normal.
Walking into Sherlock's room, John found him asleep. He put the leather holdall of clothes etc into the locker beside Sherlock's bed, and settled himself down to wait for his friend to wake up. He pulled out his copy of The Metro that he hadn't got round to reading on the tube earlier, and found himself automatically skimming the paper for cases that Sherlock might be interested in. Even now, old habits died hard.
He was aware of Sherlock's slow, even breathing as he read, then found himself listening more closely. Something was off. John knew what Sherlock looked and sounded like asleep, and what he looked and sounded like when he was unconscious, and this was somewhere between the two. His breathing was slow. Not dangerously slow, but much slower than it had been since his surgery. John's eyes flicked to the monitor. Saturations were a little low, even on the oxygen. He got up and turned up the oxygen being delivered by a couple of litres. And then he spotted the morphine pump. It was turned up to ten. He checked the concentration of the morphine on the label on the side of the syringe, swore, and reached to try to turn it down. It should have been locked by a code. It wasn't, and responded immediately to his press of the buttons, as he turned the infusion rate to zero.
'You stupid bastard,' he murmured, as he pressed the call bell for the nurse and lifted Sherlock's eyelids to check his pupils. They were tiny, pinpoint. Of course they were. The tell-tale pupils of someone who had had way too much opiate.
'He's turned up the morphine infusion,' he told the nurse. 'He's out for the count. Get the anaesthetist on for the pain team in here, will you? We might need to reverse it.'
He shook Sherlock, and then when he got no response, administered a firm rub with his fist on Sherlock's sternum; the time-honoured way of waking up a drowsy patient. This earned him a mumbled swear word, and his hand was pushed away. Not completely comatose then, good. John did a quick calculation of Glasgow Coma Score, trying to work out exactly how unconscious Sherlock was. Eyes were remaining firmly shut, earning him a score of 1; Voice - inappropriate words, or were they appropriate? He'd give him 3 for that; Movement - localises pain, 5. So his GCS was nine. Better than it could have been. But he had warned James about this, hadn't he? He'd warned him that Sherlock wouldn't be able to resist fiddling with his own morphine infusion; that he'd turn it up. Did this prove dependency, or just the endless need to solve a puzzle and prove that he was more clever than anyone else? John wasn't sure.
A very worried looking anaesthetic registrar arrived, and after a blood gas sample which proved adequate ventilation, she and John decided between them that they could safely avoid reversing the morphine. While administering naloxone to block the effects of the morphine would wake Sherlock up rapidly, it was likely to leave him in screaming agony for several hours, and morphine would then have no effect on his pain until the naloxone wore off. Worse still, if Sherlock had a true opiate dependency, then it would also precipitate withdrawal symptoms. As long as they observed him closely, it was safer to watch and wait for now, and then try to find an alternative method of giving him analgesia when he finally woke up.
James MacPherson turned up at the same time as the anesthetic consultant, who looked sheepish to say the least.
'We discussed it, John,' James told him. 'It was thought unlikely that Sherlock would be able to break the code on that particular pump in his current state. Obviously we were wrong.'
'I've known alcoholics drink the alcohol gel from the hand sanitiser dispensers,' John said, 'It's amazing the lengths that people will go to. But this is Sherlock Holmes that we're talking about. Of course he was going to crack the code. I did warn you.'
'And we've learnt out lesson,' the anesthetist said briskly. 'So what do you suggest?'
'A background infusion rate, which he can put up for a maximum of twenty minutes at a time, before it reverts to a background rate,' John said. 'Then look at how much morphine he's requiring over twenty-four hours, and adjust the hourly rate accordingly.'
'That's not dissimilar to the PCA that he disabled,' the anaesthetist pointed out.
John shook his head. 'That only gives a bolus on top of the infusion rate,' he said. 'That's why he cracked the code. He needed more than it would give him. He need control over the infusion rate to achieve the analgesia that he felt that he required.'
'He could have just - asked?' the nurse said questioningly. 'Why didn't he just ask?'
'Not his style,' John said. 'The stupid bastard always has to do everything for himself. You're going to have your work cut out for you, I'm afraid, once he wakes up.'
John sat there, reading the paper cover to cover, and drinking the tea that the nurse bought him until Sherlock finally woke up some ninety minutes later. He let out a low moan as he opened his eyes, hand going automatically to the right side of his chest.
'And that's what you get when you play silly buggers with your morphine pump,' John said, as he reached across to start the infusion again from the new pump, set according to his instructions. 'And if you do that again, Sherlock, then they'll take it away from you altogether. You know that they will.'
Sherlock shut his eyes again and lay still, waiting, John knew, for the morphine to kick in, and the pain to die down.
'Did you sort it out?' he asked, when he finally opened his eyes again.
'Did I sort what out?'
'That ridiculous PCA thing. Did you get them to change it to something more sensible?'
'Standard infusion, with a capacity for you to adjust the rate for a maximum of twenty minute at a time, and the agreement that they'll adjust the infusion rate accordingly on a daily basis, depending on how much you need.'
'Perfect - thank you.' There was an edge of smugness to Sherlock's tone.
'Thank - hang on, are you trying to tell me that you did this deliberately to get what you wanted? Sherlock you could have killed yourself - again.'
'Unlikely. I calculated the dose based on what I'd used in the past. Purity is difficult to assess when you buy it on the street of course,' he paused to yawn, 'but it sounds as if my approximation was accurate. Thank you for stopping them using the naloxone by the way.'
John glared at him, resisting the temptation to punch him.
'What?' Sherlock asked innocently.
'You are the stupidest, most inconsiderate bastard, that I ever...'
'And yet here you are,' Sherlock said calmly.
'Here I am. Again,' John said. Sherlock turned to look at him, and they both smiled. Then John sniggered and Sherlock started to laugh, then grimaced and clutched his chest again.
'Only hurts when you laugh?' John asked. 'Sorry.'
'Turn it up, will you?' Sherlock asked, and John complied.
'Sherlock - about the morphine.'
'The morphine or the heroin, John?'
'It wasn't just for a case, was it.'
'I needed Magnussen to believe that I was a drug addict.'
'And the cocaine and the ketamine? Were they part of your plan too?'
'Did Molly tell you?'
'No, we had a tox screen done after the shooting. The medical staff here needed to know.'
'The more drugs, the more convincing the -'
'Bollocks,' John cut in.
'I'm sorry?'
'You heard me. It's bollocks. You used those drugs because you wanted to.'
Sherlock yawned again and closed his eyes.
'No, you don't,' John said, reaching out to turn the morphine down again. 'You're not getting out of it that easily. This is serious, Sherlock.'
'I've just come off intensive care after major surgery, John. Do you really think this is the time to discuss this?'
'Yes, I do. Sherlock, tell me. What's going on?'
But Sherlock had closed his eyes again, and despite the lower dose of morphine was fast asleep.
John let out a groan of frustration and resisted the temptation to punch something - Sherlock probably. Pre-contemplative, was that what Mary had called it? Denial was more like it. He needed to know what Sherlock had been up to and why. He pulled Sherlock's holdall out of the bedside locker again, and extracted his phone. If he wanted to play silly buggers, then John was perfectly willing to beat him at his own game.
Sensible of him to have charged Sherlock's phone for him the night before. The battery had gone flat in the days since it had been handed to John in the Resucitation Room, together with Sherlock's other personal possessions. His clothes had gone into brown paper bags and seized by CID for forensic examination, but his wallet, phone and watch had been given to John for safe-keeping.
John flicked down Sherlock's contact list, until he found the number that he was looking for.
'Shezza?' came the voice at the other end. 'We missed you, man. Where have you been? You after some gear?'
'No,' John replied. 'I'm after some information. And I think that you, Bill Wiggins, are exactly the man to give it to me.'
If you want to know what Mary got up to whem she was meant to be with Cath, then have a look at 'Conversations and Conspiracies'. It's the first in a series of 'side conversations', running in parallel with this story. Please do have a look and let me know what you all think!
